Travelin’ man, movin’ on

Travelling (to meet, to speak, to friends)

Eight places in six weeks, none exotic other than NYC (from Pittsburgh to Mendham, Chicago, Chicago, Columbus to Orlando, Mendham to NYC and back to Mendham).  “I travel therefore I am.”  But I’m taking a different approach.  I’m staying with friends if possible, and, triangulating to Mendham to maintain a relationship with the grandkids, as Teri would do.  I’m reconnoitering old friends and colleagues, and enjoying the fruits of a lifetime of relationships some neglected and mentorship.  

In Pittsburgh (Nausea and Vomiting conference), my cyclic vomiting family - Kathleen (President, CVSA) and David (retired, new author, the godfather of CVS care) and Thangam (rising star on the adult side) – was there.  A weekend side trip to Mendham where Jack pulled me into his boy cave for block building and 

Jack's boy cave

destroying and chasing, and Naomi is a little hesitant as she enters the stranger phobic stage.

In Chicago at the annual NASPGHAN (GI) meeting, I saw many professional friends, former colleagues, mentees who have become … Associate Professors!  Most importantly, Alan (from Boston Children’s) gave out the 2^nd Teri Li Education Award to a bright energetic Christine from U. of Colorado.  We will be 

Christine - 2nd Teri Li Education Awardee

editing the 2^nd Board Review Book together.  I stayed with Modena and Gary on Lakeshore Drive next to the Navy Pier.  Modena and I go back nearly 40 years to a time when we were former fellow medical students at Kansas and pediatric residents at Wisconsin!  It allowed me to walk/bus to the meeting, yet return to a conversational, restful evening.

The next week in Chicago, after the Council of Pediatric Subspecialties meeting, I ate with John and Nancy, former Chicago neighbors, to break sushi together at Tanoshi in Andersonville on 5547 N. Clark.  This is my all-time favorite sushi place where Mike invents unique flavors using truffle oil and other seasonings.

                               

My fall highlight was a return to Columbus to give the Juhling McClung (my wonderful former chief) Memorial Lecture at Nationwide Children’s Hospital.  It was laden with emotion.  He passed away 9 years ago.  I had a chance to see Helen his widow.  Another challenge was being invited by Carlo who is the best speaker in our entire NASPGHAN society.  But my jokes about the new hospital being supersized to accommodate obese Ohio children, about performing endoscopy in the 1980’s without face mask, gown or glove and inadvertently pioneering fecal matter transfer (well before the current fecal matter transplant rage), and Nationwide winning the 4 team bowl championship bowl by having the most national presidents amongst four semifinalists Cincinnati, Toronto and Boston during the BCS era ... all hit home.  Teri would have been proud.  I had lunch or dinner with former colleague Bob, former neighbors Cindy and John, and stayed and ate with gourmet mates Susan/AJ, Rhonda/Chris, Peg/Rick while seeing my Buckeyes whomp the Nittany Lions 63-14.

Cooooooold Script O-H-I-O with 106K fans

From there to balmy Orlando for the Academy of Pediatrics to speak about vomiting.  The important asides were with my former colleague Leo, good friend Mel (UCSF, editor JPGN), and good buddy Colin now a world beater for Mead-Johnson … who passed on the flu, the big one, to me.  I also had a lovely dinner with professional friend Rob and Janet from Pitt.

Did I suffer.  Sore throat, cough, chills, myalgias, lassitude, then bloody purulent sinus drainage and matted eyes that led to systemic and ophthalmic antibiotics over 10 days.  Missed 2 days of work and should have missed more but could not let down patients who had flown in from Florida, etc.  Fortunately, Maria ended up taking care of my father (urinary tract) and me separately so I wouldn’t pass the flu to him.

In recovery, I came east to Mendham, having been invited by NYU to give Grand Rounds, and had a nice dinner with my GI friend Yosi (also a grandparent, also trying how to retire gracefully).  Onto NYC where I ate with Teri’s college buddies Lois/Dave (new grandparents), Suzanne, and Becky/Jeff (both retired!),
catching up with kidz and grandkidz, and how to appropriately behave as grandpamas.  I went to the 9/11 Memorial, Time-Life Bldg, 

 MOMA, and walked on Highline (elevated garden walk from 14^th to 34^th St.).

Becky and I freezing on the Highline

Starry night at MOMA

  At the Memorial, thought about senseless deaths, man’s inhumanity, Teri, life and resilience.  As Becky pointed out, as NYC is becoming increasingly gentrified the neighborhoods are becoming less distinctive.  NYC nevertheless pulsates with tremendous energy, palpable wherever you walk, sightsee or eat.  I recommend Ippudo a pulsating, upscale ramen restaurant on 4^th Ave between 9^th and 10^th

Becky & Lois at Ippudo (where Legan's son Akira works)

(Astor Place stop on Subway 6).  Now I’m back to Mendham, playing with Jack and Naomi in the boy cave, taking Jack to school/reading a book to his class, going to Costco, Chinese grocery, picking up fresh apples, roasting marshmellows, watching a suspended tree surgeon, and setting up of a play structure.

Dad

In the midst of my sojourns, Dad became generally weak and was found on the floor four days out of five.  I was ill with the flu and tried to manage from afar.  The first visit let to a diagnosed urinary tract infection.  After more encounters with the floor, I sent him to the Emergency Room … same findings, normal brain scan.  It took him about 13 days to gain the strength to walk down to my end of the building.  In retrospect, it was ‘just’ a UTI, but in the elderly such can disorient, can weaken, can kill.  He was lucky.

This raised all sorts of flags as Dad is not monitored for 19 hours a day.  What to do?  His doctor says he belongs in assisted living.  ‘Teri promised that I wouldn’t have to go into a home – that’s why I moved here.’  ‘Teri is no longer here and I have to work…’  Silence.  I called around but couldn’t find any short term respite care while I traveled to NYC.  So I stepped up his current care, morning, noon, evening, hoping for the best.  I have to make this difficult decision alone as my sister is unable to contribute.  In the meantime, I continue to worry … 

Whereas many of my friends’ elderly parents similarly resisted being institutionalized, most seem to have adjusted well.  But my father simply wants to do his own thing (read, write, watch TV) independent of social interaction, and eat only Chinese food.  So, I am not sure he would do better, psychologically.

Kidz

Jack is now an experienced Montessori pupil (3^rd generation), full of energy, playfulness, and humor.  Naomi (nicknamed Godzilla – ‘nothing gets in my way’) is starting to walk Frankenstyle, and is warming up to me.  Both just crossed the 3^rd and 1^st year marks.  Jack has sharp ears (repeats a conversation) and a definite sense of humor.  Naomi is a bundle of fearless energy climbing up steps and onto

Playing 'heads up' peek-a-boo

 tables to reach the top of the heap.  John completed a second major acquisition for his company.  Rachel is enjoying being a home manager and juggler.  She just completed a half marathon a week ago in 1:35.  John also just completed a 200 mile team ultramarathon with 5 other members.  Ben passed his first national USMLE exam, and completed internal medicine and pediatric rotations, still enthused and passionate.

Moving on. 

In February, many friends began to speak to me about moving on with my life.  ‘It’s time for you to live for yourself’.  ‘You have to move forward.’  ‘You have another life ahead of you, you’re still ‘young’’.  ‘You’ll know when the time is right.’ 

From the frying pan to the fire, a blistering transition from 19 months of death defying care of Teri to 26 months of continuous care of my father.  There wasn’t any real down time for grieving, for clearing, for moving on.  For the longest time, I kept her clothes in the closet as a comfort measure, as if she had just gone on a long trip.  I only cleared out them out a month ago.  I did reach equanimity with Teri’s illness as it indelibly impacted my life.  I am still trying to reach the acceptance stage with my father as he was so absent in my life … I ironically am doing so much more for him than vice versa. 

So re-entry is a difficult challenge for obvious logistical (energy) reasons.  Then there is uncertainty, since I haven’t done so for 40+ years.  Then there are the comparisons, how will she compare, but that’s unfair.  But as my nurse said, ‘[By being so good,] Teri ruined it for you.’  And so on.  It is new territory, uncharted for me.